Frontal bossing
Frontal bossing is an unusually prominent forehead. It is sometimes associated with a heavier than normal brow ridge.
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Considerations
Frontal bossing is seen only in a few rare syndromes, including acromegaly, a long-term (chronic) disorder caused by too much growth hormone, which leads to enlargement of the bones of the face, jaw, hands, feet, and skull.
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Causes
Causes include:
- Acromegaly
- Basal cell nevus syndrome
- Congenital syphilis
- Cleidocranial dysostosis
- Crouzon syndrome
- Hurler syndrome
- Pfeiffer syndrome
- Rubinstein-Taybi syndrome
- Russell-Silver syndrome (Russell-Silver dwarf)
- Use of the antiseizure drug trimethadione during pregnancy
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Home Care
There is no home care needed for frontal bossing. Home care for disorders associated with frontal bossing varies with the specific disorder.
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When to Contact a Medical Professional
If you notice that your child's forehead looks overly prominent, talk to your health care provider.
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What to Expect at Your Office Visit
An infant or child with frontal bossing generally has other symptoms and signs. Taken together, these define a specific syndrome or condition. The diagnosis is based on a family history, medical history, and thorough physical evaluation.
Medical history questions documenting frontal bossing in detail may include:
- When did you first notice the problem?
- What other symptoms are present?
- Have you noticed any other unusual physical characteristics?
- Has a disorder been identified as the cause of the frontal bossing?
- If so, what was the diagnosis?
Lab studies may be ordered to confirm the presence of a suspected disorder.
References
Kinsman SL, Johnston MV. Congenital anomalies of the central nervous system. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 609.
Michaels MG, Williams JV. Infectious disease. In: Zitelli BJ, McIntire SC, Nowalk AJ, Garrison J, eds. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 13.
Mitchell AL. Congenital anomalies. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 30.
Sankaran S, Kyle P. Abnormalities of the face and neck. In: Coady AM, Bower S, eds. Twining's Textbook of Fetal Abnormalities. 3rd ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2015:chap 13.